Sairenji Tomoko, Griffin Samuel, Keen Misbah
University of Washington, Department of Family Medicine.
PRiMER. 2020 May 12;4:8. doi: 10.22454/PRiMER.2020.550339. eCollection 2020.
High-quality, experiential learning in outpatient settings is indispensable for medical student education; however these settings are difficult to recruit and retain. The majority of primary care physicians are employed by organizations and are under pressure to increase their relative value unit (RVU) production. Although the common perception that teaching medical students decreases productivity is unproven, it is likely a barrier for primary care physicians pursuing clinical teaching. We sought to investigate whether medical student teaching affects clinical productivity.
We recruited 15 family medicine (FM) clerkship sites to participate in our study via email and at an in-person meeting. For each preceptor, we collected billing data in the form of current procedural terminology (CPT) codes for all patient encounters and the number of patients seen per half-day for when the preceptor had a student and when they did not. We converted CPT codes to RVU data. We compared differences in productivity for each individual preceptor, and we used a paired test to examine collective data with and without a student.
Ten preceptors at six FM clerkship sites provided reliable data. The average RVU per half-day without a student was 10.84, and it was slightly higher at 11.25 when a student was present (=.74). The average number of patients seen per half-day without a student was 8.32 and it was slightly lower at 7.87 when a student was present (=.58).
This study shows promising data that teaching students in the outpatient setting does not decrease preceptor productivity. This pilot study can lead to a larger-scale exploration of family medicine preceptor productivity in different settings and institutions.
门诊环境中的高质量体验式学习对医学生教育至关重要;然而,这些场所难以招募和留住学生。大多数初级保健医生受雇于医疗机构,面临着提高相对价值单位(RVU)产出的压力。尽管认为教医学生降低工作效率这一普遍看法未经证实,但这可能是初级保健医生从事临床教学的一个障碍。我们试图调查教医学生是否会影响临床工作效率。
我们通过电子邮件和一次面对面会议招募了15个家庭医学(FM)实习点参与我们的研究。对于每位带教老师,我们收集了所有患者诊疗的当前程序编码(CPT)形式的计费数据,以及带教老师带学生和不带学生时每半天看诊的患者数量。我们将CPT编码转换为RVU数据。我们比较了每位带教老师的工作效率差异,并使用配对检验来检查有学生和没有学生时的汇总数据。
六个FM实习点的十位带教老师提供了可靠数据。不带学生时每半天的平均RVU为10.84,带学生时略高,为11.25(P =.74)。不带学生时每半天看诊的患者平均数量为8.32,带学生时略低,为7.87(P =.58)。
这项研究显示了有前景的数据,即在门诊环境中教学生不会降低带教老师的工作效率。这项试点研究可以促成在不同环境和机构中对家庭医学带教老师工作效率进行更大规模的探索。